HomeMy WebLinkAbout16745-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218274 Date AUGUST 14, 1989
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 840 BRIDLE LANE CUTCHOGUE
House No. Street Hamlet
County Tax Map No. 1000 Section 102 Block 08 Lot 16
Subdivision HIGHLAND ESTATES Filed Map No. 6537 Lot No. 19
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEB. 8, 1988 pursuant to which
Building Permit No. 167452 dated FEB. 19, 1988 _
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is ONE FAMILY DWELLING ATTACHED GARAGE REAR DECK.
The certificate is issued to MICHAEL & REGINA DWYER
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 87-SO-250 AUG. 10, 1989
UNDERWRITERS CERTIFICATE NO. PENDING SLIP 3ULY 27, 1989
PLUMBERS CERTIFICATION DATED REGINA DWYER AUG. 10 1989
Bu' ding Inspector
Rev. 1/81
Fosas xo. a
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION Of THE WORK AUTHORIZED)
N a 16 7 4 5 Z Date ,~...r~ , I9.~.r..8
Permission is hereby granted to:
to
at premises located at .....~~3/':.~~..... .~:~~..,yCI~
...........................................~"'7"~.r7........... J. ..6..............................................................
................................................................../.............................................pp.a~.............................................
County Tox Map No. 1000 Section ....lf.J..:~........ Block ®.~.4..... Lot No.........
pursuant to application doted .....c.~~.../~~ 19.Gl.~and approved by the
Building InQspector./'
fee $.~7.~/~~(' .
!..(e~~..................
ui1 Inspector
Rev.6I30/80
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TEL. 7GS-1802
~oc~~FFOLS'Cp~ xOti°JN OF Sf~YJ~'F30d.~
" • ~ OFFICE OF BUILDING INSPECTOR
~ P.O. BOX 728
c°n~~` ~ TOWN HALL
l SOUTHULD, N.Y. 11971
o~M01 ~ ~~o.~
C E R T I F I C A T I O N '
Date ~
Building Permit No. /lp 77'~
(please print)
Plumber 1P Q., ~
( ease print!
I certify that the solder used in the water supply system
contains less than 2/10 of 1~ lead. ,
~Gec.~
(plumber's si ature)
Sworn to before me this
19 rS]~~:Cplpp
R1i
Notegr Public, State of NewYark
Hotar7 Public, County No. 4822683,SuE(olkCouMy~
Term Expires December 31,18._._.
~ TONN OP SOUTBOLD
BUILDING DEPART:ICNT
TOUN IIALL
SOUTIIOLD, NEN YOILiC 11971
765 - 1802
+ APPLICATION FOR CL•RTIFICATE OF OCCIIPAtlCY '
DATE. } :
i ? _
NEN CO:iSTRUCTION d. ...OLD OR PRE-EBISTILJG BUILDTNG_...__VACANT LA2tD........
Location of Property_.~~®__~1~:1~~~/.(~.`~Lr:.~~~d•o'Y:~~-J} U~.~_~
UOUSE ti0. STRL•nET ? UAHLET
Ovncr or Ovncrs of Property..~~~!~e~'~!C..,µ..l,Y.~~.n~1_..:"~~.~~~„_..,.,.
County Tax Hap No.%1~~000 SeJcti(on ,~S/~ Block Lo e' ../SP..._
Subdivision_,~,yh/~~~.~.s?_~~~:.~ Filed Map (p~~.I.Lo[..1~.....
PcrniC :to. ~~~Datc/-of Pcrmic `.'ZL.~,ZS~...Applicant ~~1AQ:..i!~J.°rr.
iIcalth DepC. Approval ..CS1,~V Undcrvritera Approval......_./.....
PLannin~ Board Approval
:tcquc:t for Tempora•rfy Certificate .......,Final Certificate
.l ^
APPLICANT ~ ~ C~... .l..,t.._........
~e~, .37~/~7
toiltlaa
M 1
FORM N0. 6
• TO67N OF SOUTI]OLD
BOILDINC DEPARTMENT I',
TOWN NAL
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
A. 'This application must be filed in typewriter OR ink and submitted to the Building
Inspector vith the following; for new buildiogs or new use:l
1. Final survey of property with accurate location of all buildings, property Hues,
streets, and unusual natural or topographic features. '
2. Final approval of Bealth DepC. of water supply and sewerage-disposal~S-9 farm).
3. Approval of electrical installation from Board of Fire Uddervriters.
4. Sworn statement from plumber certifying that solder usedlin system contains less
than 2/10 of lz lead.
5. Commercial buildings, industrial buildings, multiple residences and similar, '
buildings and installations, a certificate of code compliance from the Architect
or Engineer responsible for the building. I!
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings ~PrlOr to April 9, 1957, non-conforming uses, or buildings
and "pre-existing". land uses:
1. Accurate survey of property shoving all property lines, streets, buildings and
unusual natural or topographic features.
2. A properly completed application, a consent to inspect signed by the applicant
and a certified abstract of title issued by a title company which shall
shov single and separate ovncrship of the entire lot prioi to April 9, 1957.
If a Certificate of Occupancy is denied, Che Building Inspector shall state the
reasons therefor in writing to the applicant. ~
3. Date of any housing code or safety inspe'cCion of buildings` or premises, or other
pertinent information required to prepare a certificate.
C. For Vacant Land Certificate of Occupancy:
1. An application for vacant land Certificate of Occupancy shall be submitted,
and a certified abstract of title issued by a title compa~iy showing single and
separate ownership of the entire lot prior to April 9, 195',7 shall also accompanq
the application. If a Certificate of Occupancy is denied, the Building Inspector
shall state the reasons therefor in writing to the applicant.
D. FEES:
1. CERTIFICATL' OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00,
Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00
Addition Co Accessory buildings, $25.00 - Businesses $50.00.
2. Certificate of Occupancy on pre-existing dwelling $10.00.
3. Copy of Certificate of Occupancy $5.00 - over 5 years - $10.00
4. Vacant Land Certificate of Occupancy - $20.00
5. Updated Certificate of Occupancy - $50.00
6. Temporazy Certificate of Occupancy - $(5.00 Residential
$50.00 Commercial
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FOUNDATION (2nd) -
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ItJSULATI0C7 PER N. Y.
STATE ENERGY
CODE
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ADDITIOt7AL COMMENTS: ~
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ~INAL
REMARKS: ~~,Q~Q
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DATE / INSPECTOR
4
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7G5-1802
BUILDING DEPT.
INSPECTIt3N
[ ]FOUNDATION i5T ( ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ~ FINAL
REMARKS: ~ Z~ ~a~ ~ J~~ Z
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DATE ~0 _INSPEGTOR '
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T65-1802
BUILDING DEPT.
INSPECTION
(]FOUNDATION 1ST ( )ROUGH PLBG.
(]FOUNDATION 2ND [ ]INSULATION
~RAMING (]FINAL
REMARKS: T - D/~-
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DATE ~y INSPECTOR ~i
765-1802
BUILDING DEPT.
INSPECTION
[ ] F UNDATION 1ST [ ] ROUGH PI.BG.
[)FOUNDATION 2ND [)INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: Q ~
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DATE ~ INSPECTO
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765-1802
BUILDING DEPT.
1 NSPECTI
[d] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
FRAMING) / FINAL
REMARKS: ll./ lC ~
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DATE INSPECTOR
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THE NEW YORK BOARD OF FIRE UNDERWRITERS o-'Rac:f~, °
y-t)f(TOt;b BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
iarrrr3srr a,1,.3~1~~Tx T,~,~32~ts~+IR~ z3 (tfl„33~k
Date Application No. on file
THIS CERTIFIES THAT
only the electrtco! equipment as deacrihed 6ebw and introduced 6y the applicant named on the shove application numher in the premises of
7`1TK.E TiM(Yf:h'., Hh'tf~T+47 il;<sNE•;r 4iftk 3Y~t.,`,t3T:lhdts~ C1T`l"C:#YCSGL£P, P+f.k`.
in the following (<rcation5 g s ent ~ Ist FI. ~ 2nd h'!. ,i1R f ~ 7"3' ~i< Sevtion Block Lot ~i W)
,JY3GY ~l't, '1`ZS($~
wos erarnined on and found to 6e to coneylianrn with the regoireneenlx q(thiy Board.
FIXTURE ECEPTAClES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K W. AMi. K W. AMT N.W AMi K.W. AMT. H P.
31. liS a,1, ~ `7,1 t ~3 1 1 ;
DRYERS FURNACE MOTORS FUTURE APPLIANCE fEEDER$ SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
pMT. K. W. Oll H. P GAS H. P. AMT. NO. A. W G AMi. AMP. AMi. AMPS. TRANS. AMT H. fl SYSTEMS AMi. WATTS
NO.OF FEET
4 1<' T rn 1,3 1
SERVICE DISCONNECT NO.OF S E R Y { C E
AMi. pMP. rypE METER I ]W 19 3W S.e' 3W 3,e' dW NO. OF CC COND A. W G. NO OF HbIEG W. G NO OF NEUTRALS A. W G.
EQUIP. PER ,e' OF CG COND. OF HIiEG OF NEUTRAL
~:~I~ yi ~ .L KA~~ 1111
OTHER APPARATUS:
S,i£1KH; 3181°F;C t OR ~ -
~2~4%cc-c~-~ -Pc"~
Gr~.RY F'12F~tUi'Ifia.F, b,IIF;I'T~J.(: i,h~(1.~36A>4-~
f9 1ntAGNU"t~t~ AYF..
LkitCl°; Itc;lYK.I)Tdiff)YQftr N'Y, 1~77~) GENERAL MANAGER
Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OP CERTIFICATE MUST NOT BE ALTERED {N ANY MANNER.
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~f=~:l~r, ~ ~ BOARD OF HEALTH
11 ~ f. i..l~ ~ f 'a air.: .
~~~J ~~.:=,~t.:.,~..,.....r..r..._.,._~~ ~ 3 SETS OF~PLANS ° V
g rl FORM N0. 1 SURVEY K
FEB $1988 ~ !3?; • • • -
TOWN OFSOUTHOLD CHECK -
L ....~®,.,..,.._„_,.,_.,I. BUILDINGDEPARTMENT SEPTIC FORM
BI.gC,. grs>r. TOWN HALL
TOW(VUFSOUTMOLb „pUTHOLD, N.Y. 11971 NOTIFY ~3 ~ ~~Sr
, TEL.: 765-1802 CALL
MAIL T0:
Examined~G/~/..........., 198
Approved .~~~,1`.........., 19~~,PermitNo.~6~!.~.~
Disapproved a/c
uil g Inspector)
APPLICATION FOR BUILDING PERMIT
Date . 19
~ INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans,accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary ' tions.
r~~
(Sign ure of applicant, or n e, if a corporation)
..1.a?./o..l.~~~t.t~.f~~.,..~11.fi~ho. u.~.,.~..~~
(Mailing address of applicant)' I l 9 9~ J
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.....~u~n~r
Name of owner of premises • • • 1•rl • • ~ ~ . • • • Y
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No . . .
Plumber's License No . .
Electrician's License No. .
Other Trade's License No . .
,7
1. Location of land on which proposed work will be done.`.'~.d.~. N~~h/any! ..~5.~~.~"~'~.......... .
House Number Street ~ Hamlet
County Tax Map No. 1000 Section ~ , Block ..a ~ ~ Lot
/ ry p............
Subdivision ~7./ ~11. ~l~l~ 4~ ...E~fc?-'~'e~ Filed Map No. . lRJ`~. Lot / , .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . , ~~.Y.1,-~; ~e~:Y,1.~ . . .
b. Intended use and occupancy .....5/1~~1~.~w2./i'7.i.~~...Q~i,t3.GL~L~1,Q' , i .
3. Natur of work (check which applicable): New Building ~ Addition Alteration . , .
Repai , oval Demolition , . i blthe ~i1~rk .
Rem' 6.1'
4. Estrm tad Cost Description)
~"~9'"°°'.?! Fee..........................
' (to be paid on filing this application)
5.. If dwelling, number of dwelling units Number of dwelling units on each floor . .
If gar ge, number of cars o~ , , .
6. If bus ness, commercial or mixed occupancy, specify nature and extent of each type of use . ~ . .
7. Dime sions of existing structures, if any: Front ..ld,
fl!~~....... Rear Depth , .
Heigh Nurrjber of Stories .
Dime sions'of same structure with alterations or additions: Front Rear .
Dept ..Height ......................Number of Stories .
8. Dime sions of entire new construction: Front ...St~.f'e~}.... Rear ...fib. ~ .........Depth .4?~.~......... .
Heigh a.? ~ .Number of Stories ..a7~ .
9. Size o lot: Front ' Rear pQ r.. ~~!..~4~'
fl," 'y. g~.. Name of Former Owner .,~~.Y!~.~~Cc~;f;J t
10. Date c~f Purchase i , . .
1 I. Zone ruse district in which pr~mises are situated . P'GS p',¢, n, f.ia ( .
12. Does roposed construction vio#ate any zoning law, ordinance or regulation: , !!/b '
13. Will 1 t be regraded ~ ust . ;~~t~?41$p~P.? .........Will excess fill be removed from premises: Yes
14. Name of Owner of premises /Yj,~h~el ~~ey; na, ~µ,ye~,ddress !a-`F!~GJest, IQd,~,rrg35; phone No..~3`.l.'~`~?S , . ,
Name of Architect t~i ~ ~ .....Address . . ......Phone No... .
.
Name of Contractor S~...... .
W n ~ ~ ! W.. Address ~
............Phone No..7..3,rI.:. Y.7.~.~.. .
15. Is t is property locatedl,within 300 feet of a tidal wetlandY *Yes No
*If y s, Southold Town Trustees Permit ma be re uired.
PLO DIAGRAM
Locate clearly and distinctly al); buildings, whether existing or proposed, and, indicate all set-back dimensions from
property li es. Give street and blockinumber or description according to deed, and show street names and indicate whether
interior or corner lot. tr'ir ' ~t 1~ t.a, n ~ _ _
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STATE OF NEW YORK, , - ,
i S.S
~?.r~. f/. , , , --being duly sworn, deposes and says that he is the applicant
(Name of individual rgning contr
above named.
He is the
~V~~~~ ~ (Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Swom to before me this
Notary Public, ..7~' County
HELEN R DE YO . V. , . p .
(Sig tare of a plicant}
NOTARY PUBLIC, State o}
New York
No. 4707878, Suffolk County
Term Expires March 30,19
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SURVEY FOR
SUFFOLK COUNTY~DEPARTMENT OF HEALTH SE>4UICES M/CHAFE OWYER Q REG/NA OWYER
SINGLE FAMILY DWELLING 0 LV Auc 7, /ses
Dr~.FAUG 1 ®198p LOT NO. /9, H/GHLAND ESTATES MAR 2B, ises
M.S. RcF. No. 9.5'0 o~5fl AT CUTCH06E DATE OCT. 28, /9B7
The se'aage disposal end water supply facilities for tins TOWN OF SOUTHOLD SCALE = 50'
In' nave been mspeciep by this 0euartmentand/ar SUFFOLK COUNTY, NEW YORK Ho. 67 - l/70
DTliel ageooles ;rncT~,;fmt4~~,;d tto sate ac(.wy. 1-~.~
ti' ~ • ~=~~"~i~~a, L N WMUiN01112E0 ALTERATION OR AO DITION m THIS GUARANTEED TO
sunvEr O A vlaAnoN aF EECrION 7209 OF THE MICHAEL D ~ F bf p.
Chief of Borea of Wastee~ater Management. NEW YORK'STAT[ EDVCATION LAW REGINA
N COPIES OF TN13 SURVEY NOT BEARWO THE LANG
SURVEYOR'S INKED SEAL ORENBOSSEO SEAL SHALL COMMO t{p_AtJD A INSURANCE CO.
NOT B[ CONSIDERED TO BE A VALID TRUE COPv
N GUARANTEES INDICATED HEREON SHALL RUN ONLY TO i' mA
HEALTH DEPARTMENT -DATA FOR APPROVAL TO CONSTRUC i THE PERSON FoR wNOM THE SURVEY IS PREPARED O b~
AND ON NIS BENA LF TO THE TITLE COMPANY, GOVF1tN- 2'
N NEARCST WATER /AIM~MI. ~ MSOURCE Of WATERS MIWTE PUBLIC- MENTAL AGENCY AND LENDING INSTITUTION LISTED
M EllFi CO. T1%MA? OIGT /OOO SECTION /02 GIDCK OOB LOT HEREON, AND TO ME ASlION EES OF THE LENDING ~L
NTNERE ARf ND DWELLIINE WITHIN 100 FEET OF TNIf PROPERTY INSTITUiIpI. 6UARANTEE4 ARE NOT TRANSFERABLE
OTN[R TNAM THOSE"SHOWN N[REON. TO AOOI TIOMAL INSTITUTIONS OR SUBSEQUENT
N THE WATER fU?RY AMD SEWAGE DISPOSAL SYST[M fdl THIS RESIDE MCE OWNERS
WILLCWfORM TO TN[ EIAMDARDE Of TML SUffOLK COUNTY DEPARTMENT N0I STANCES 5110WN 'HEREON FROM PROPERTY LINES
Of HEALTH EUtV IC[E TO E%ISTING STRUCTURES ARE FOR A SPECIFIC ~ 0• 4S
AMUCANT~ - PROPERYYAIINE SRORNFORT HEEEREC TION OFTFENIC ES C~NSFD LAND SU84Ero4
AooREu
TEL YOUNG 8r YOUNG R~IVOERHE DA
NNEW~YORrKE
NOTE: ¦=MONUMENT STAKE ALDEN~W.YOUNG,PROFESSIONAL ENGINEER
SUBO/V/S/ON MAP F/LED /N THE OFF/CE OF THE CLERK AND LAND SURVEYOR N.Y.S. LICENSE N0. 12843
OF SUFFOLK COUNTY ON APR.26, /977 AS F/LE NO. 6537
HOWARD W. YOUNG, LAND SURVEYOR
N tNE LOUTKw Of WI1.uwJ,SEPTIC TANKIGT)G CLSS?OOLS(CP) EIIOWM NEIIEON N.Y S. LICENSE N0.45893 '
ARE ?110M fi[lD OM[RMITIONE AMD OR DATA OGTAIMLO FROM 07HER S
e RANDIS 5 SONS IIIC. 1046
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SURVEY FOR s
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVYC'P~ M/CHA~E'L DWYER B RE(i/N.4 IJWYER
LOT NO. /9, "H/GNLAND ~srAr~-s°
DATES OCT, 28, 1987
FOR PR AL OF CON57RUCTION ONLY AT CUTCHOGE
_ TOWN OF sourHOCO SCALE 50'
REF, N ~ ~ ~ SUFFOLK C(3UNTY, NEW YORK N0. 87 - I/70
UATE I
N UNAU TNORIZ EO A4 TCRATI ON OR ADDITION TO THIS
SURVEY D A VIOlAT10N OF SECTION 7207 OF THE
HEW YORK STATE EWCATIOM LAW ~ry'(~ ®F IY~~,
APPROVED N caPle} of THIS aunv£v Nor BEARwG rNE l.ANO
NOT p
YCONS DEREO TOLBE A VA ~~O 3T UE COPY HA II ~~g' ~ p0~~
_ NGU ARANTCES INDICATED HEREON SHALL RUN ONLY TO $y
THE PERSON FOR WHOM THE SURVEY IS PREPARED Pm
NEAL7N DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT ANO a+ wg BONA IF TO THE TITLE COMPANY, 60VERN-
# NEAREtT WATCR gAIN_.MI.I NSOURCE aF WAT£R~ PRIVATE ° PUBLIC... MENTAL AGENCY AND IENDINO INSTITUTION LISTED
M SUFF CO. TA%MAP DIST /OQO yEC TION 1QZ.._ MACK RR$ LOT HEREON, AND TO THE A3316N EES OF THE ICNDIN6 .r
NTII[PE ARE NO DWElLIN43 WITHIN 100 FEET OF THIS PROPERTY INS TITU71pN. OUARA NifEB ARE NOT TRAM gFERA RLE
OTHER THAN THOSE SHOWN HEREON, TO ADOI TIONAI INSTITUTIONS OR SUBSF.OVENT Q
M THE WATCR SUPPLY AM7 SEWA7E DI}tMSAI SYSTEM F001 THIS RESIDENCE OWNERS 8 v .P
N 01 STANCES SHOWN HEREON FROM PROPERTY IINEa 9g' (if(~"
WILL CONFORM TO THC STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT TOE%I}TING STRUCTURES ARE FOR A 7PEC1 pIC
OF H[ALTN SEM'ICCS. PURPOSE ANO ARE NOT TO BC USED TO E}TAB USN ~0
ATLICAN7~ PROpERYY LINES OR FOR THE ERECTION OF FENCES (AHD SUUVE
miehtle I g- ~eglaeL. ~bw~ r
ADDRESS U~nst O_f. ~t~e '
I~f, Y e / ~T_TEL.'ry•~~%7y 7S" ~ YOUNG ~ YOI.JNG RR~RHEA(~~NEwAORrKE
NOTE: IA1= MONUMENT STRKE 1,~1~T ALDEN W.YOUNG,PROFESSIONAI ENGINEER
SU80/V/S/ON MAP F/GEO IN THE OFF/CE OF THE CLERK AND LAND SURVEYOR N.Y,S. LICENSE N0.12843
OF SUFFOLK COUNTY ON APR.26, 1977 AS F/LE NO B.53T
HOWARD W. YOUNG, lANO SURVEYOR
#TIIE LOCATION OR W0.L(W),SCPTIC MMK(St)B CEl.4POOI,SICP)SNOWN MF.P.CON N.Y. S. LICENSE N0.4589a
ARE FPOY FIELD 4Rg{RVATIONS AND OR DATA OBTAINED FROM DINERS
RRANOIS & SONS INC. 1045
If copper tubing is used iu~ ~o
~ ><odRt )o
for water distributin ~ • eq IIQys 6uidid :welsAS .
9 BuRngtASip ~eiQ/N Mj
system; piping shall be peon si 6uign~ ~addoa p
of types K or L only _ pCCUP~NCY OR
USE IS UNIA~IFUI
~~~~~~ThCUT CERTlF~CATE
SUP~ys
STEMCgAiNOT ON LEADCOMENTBEfORE ~~~~~~N~Y
EXCEED 2/10 01 fA6 ~4D CERTIF/GATE Of OCCUPANCY
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